Published in El Pais, 27 October 2020.
During the days with the highest number of hospitalizations and deaths due to COVID-19, many questioned the high prices of hospitalization in Bolivia. The social movement was so strong that even the government felt pressure to harmonize the prices of private clinics with those of the public system. After all, there are only minor differences in offered services and only these are the only reasons that can raise the “reasonable price”.
It was said that, due to the pandemic, the government would pay for the services of the private sector as it was a national emergency, and the public health system was insufficient. It would be the government that would pay the private services to compensate for this insufficiency on the part of the public service. However, when the situation calmed down, the issue was suspended. Both the population and the government have not seen the need to make changes in the health system. And this is worrisome.
The COVID-19 crisis has revealed many weaknesses in the health system and the urgent need to carry out a restructuring to improve the quality of the health system and for this, a strong leadership of the Ministry of Health is important to implement the vision of the Bolivian health as a need and a right without access barriers. However, the crisis is barely passing, and everything is returning to what it was before. A few days ago, a beloved relative passed away after being two days in an intensive care unit (ICU) and the bill was eight thousand dollars. How can a price of 4000 $ us / day be justified? What is the role of the government as the rector of health?
“If you want to have what you have never had, you have to do what you have never done.” We know this saying, but in Bolivia, it seems that the status quo anchors us more to the old practices, even though we know they are bad. Many countries are taking advantage of the changes implemented and the shortcomings evidenced to make the necessary investments and quality control points in the system. Europe has started a calculation to see the efficiency of the system by analyzing costs related to quality and efficiency. A day in the ICU costs: € 1,040 in Germany, € 1,333 in Italy and € 1,243 in the Netherlands and now are seeing how to equalize these costs with efficiency to continue improving its quality. Bolivia should not go back to the old practices knowing that our health system is precarious and inaccessible to the people.